JP2021004740A - がんのバイオマーカーおよびがんの発症を判定する方法 - Google Patents
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Abstract
Description
[1]尿中の胎盤性ロイシンアミノペプチダーゼからなるがんのバイオマーカー。
[2]がんが、卵巣がん、子宮体がん、腎臓がん、前立腺がん、胃がん、膵臓がん、食道がん、絨毛がん、または乳がんである前記[1]に記載のバイオマーカー。
[3]がんが卵巣がんである前記[1]に記載のバイオマーカー。
[4]卵巣がんの発症を判定する方法であって、被験体の尿中の胎盤性ロイシンアミノペプチダーゼ量または胎盤性ロイシンアミノペプチダーゼ活性を測定する工程を含む方法。
[5]被験体が、画像診断において悪性または非悪性の判定が困難な卵巣腫瘍を有する個体である前記[4]に記載の方法。
[6]卵巣がんの発症が、切除手術後の再発である前記[4]に記載の方法。
[7]胎盤性ロイシンアミノペプチダーゼ活性を測定する工程において、被験体の尿をメチオニン存在下でL−ロイシン−p−ニトロアニリドと反応させ、生成したp−ニトロアニリド量を測定する方法を用いる前記[4]〜[6]のいずれかに記載の方法。
本発明はがんのバイオマーカーを提供する。本発明のがんのバイオマーカー(以下、「本発明のバイオマーカー」と記す)は、尿中の胎盤性ロイシンアミノペプチダーゼ(以下、「P−LAP」と記す)からなるバイオマーカーである。特許文献1には、卵巣がん患者から分離されたがん組織中のP−LAP量を測定することにより、がんの予後を評価できることが記載されている。しかしP−LAPは蛋白質であり、腎機能が正常であれば尿蛋白は陰性であるため、当業者は尿中のP−LAPを卵巣がんのバイオマーカーとして使用する動機を持ち得ない。さらに、本発明者らは、尿中P−LAPが血清P−LAPより、卵巣がんに対して鋭敏であり、卵巣がんの有無による変化が顕著であることを確認している(実施例参照)。すなわち、尿中のP−LAPを卵巣がんのバイオマーカーに用いることは当業者が容易になし得ることではなく、血清P−LAPより尿中P−LAPがバイオマーカーとして優れているという効果は、容易に予測できない格別顕著な効果である。
・子宮体がん(Shibata K et al. P-LAP/IRAP-induced cell proliferation and glucose uptake in endometrial carcinoma cells via insulin receptor signaling, BMC Cancer 2007, Jan 19; 7:1)
・腎臓がん(Kuriyama M et al. Clinical evaluation of serum placental leucine aminopeptidase (P-LAP) activity in renal cell carcinoma, Nihon Hinyokika Gakkai Zasshi 1987 Jul; 78(7):1220-6.)
・前立腺がん(Lerman B et al. Oxytocin and cancer: An emaerging link. World Journal of Clinical Oncology. 2018 Sep 14; 9(5):74-82.)
・胃がん(Lerman B et al. Oxytocin and cancer: An emaerging link. World Journal of Clinical Oncology. 2018 Sep 14; 9(5):74-82.)
・膵臓がん(Lerman B et al. Oxytocin and cancer: An emaerging link. World Journal of Clinical Oncology. 2018 Sep 14; 9(5):74-82. 、Nagasaka T et al, Immunohistochemical localization of placental leucine aminopeptidase/oxytocinase in normal human placental, fetal and adult tissues, Reproduction Fertility and Development 1997; 9(8):747-53.)
・食道がん(Lerman B et al. Oxytocin and cancer: An emaerging link. World Journal of Clinical Oncology. 2018 Sep 14; 9(5):74-82. 、Nagasaka T et al, Immunohistochemical localization of placental leucine aminopeptidase/oxytocinase in normal human placental, fetal and adult tissues, Reproduction Fertility and Development 1997; 9(8):747-53.)
・絨毛がん(Nagasaka T et al, Immunohistochemical localization of placental leucine aminopeptidase/oxytocinase in normal human placental, fetal and adult tissues, Reproduction Fertility and Development 1997; 9(8):747-53. 、Ino K et al. Expression of placental leucine aminopeptidase and adipocyte-derived leucine aminopeptidase in human normal and malignant invasive trophoblastic cells. Lab Invest. 2003 Dec;83(12):1799-809.)
・乳がん(Jose manuel Martinez-Martos et al. Kidney aminopeptidase activities are related to renal damage in experimental breast cancer, Journal of Clinical and Molecular Medicine. 2018 Doi: 10.15761/JCMM.1000105)
本発明は、卵巣がん発症の判定方法または卵巣がん発症の判定を補助する方法を提供する。本発明の方法は、医師による卵巣がんの診断を補助することができる。卵巣腫瘍は良性腫瘍、境界悪性腫瘍(良性と悪性の中間的な性質を持つ)および悪性腫瘍(卵巣がん)に分類されるが、悪性腫瘍(卵巣がん)と非悪性腫瘍を、病理組織検査を行わずに判別することは非常に困難である。本発明の方法は、悪性腫瘍(卵巣がん)と非悪性腫瘍を、高い特異度で判別することができるので、非常に有用である。また、本発明の方法は、卵巣がんの発症を早期に判定できるだけでなく、卵巣がんの切除手術後の再発を早期に判定できる点で非常に有用である。
1−1 材料および方法
(1)試料
画像診断などで良性、悪性の診断が困難な卵巣腫瘍患者(25例)の同意を得て尿を採取し、試料とした。
(2)尿中P−LAP測定方法
ロイシンアミノペプチダーゼ測定用キット(株式会社セロテック)を使用した。具体的には、第一試薬160μLおよび第二試薬40μLをチューブに加え、L−メチオニンを終濃度20mMになるように添加し、尿を4μL加え、37℃で5分間インキュベートした。分光光度計を用いて405nmの吸光度を測定した。
(3)病理診断
上記25例の卵巣腫瘍患者については、その後手術を行い、卵巣腫瘍を摘出して病理組織検査によって、良性、悪性の診断を行った。
結果を図1および表1に示した。25例中10例が悪性、15例が良性〜境界悪性(非悪性)であった。悪性腫瘍患者の尿中P−LAP(平均値:43.4mU/mL)は、非悪性腫瘍患者の尿中P−LAP(平均値:6.8mU/mL)より顕著に高値であった。カットオフ値を15mU/mLに設定すれば、感度90%、特異度100%であった。なお、良性〜境界悪性15例の内訳は、チョコレート嚢腫7例、成熟奇形腫2例、粘液性嚢胞腺腫2例、線維腫1例、粘液性境界悪性腫瘍2例、漿液性境界悪性腫瘍1例であった。悪性腫瘍10例の内訳は、明細胞がん4例、内膜がん2例、粘液性がん1例、漿液性がん2例、未分化がん1例であった。
上記25例中5例(良性2例、悪性3例)については、血清中のP−LAPを測定した。測定方法は上記(2)と同じである。結果を表2に示した。悪性腫瘍患者と良性腫瘍患者の血清P−LAP値に差は認められなかった。
卵巣がん患者の手術前、手術後、再発時の尿中p−LPAを測定した。同時に、腫瘍マーカーである血清CA125および血清CA19−9を測定した。この患者は、手術は2018年5月9日に手術を行い、同年5月22日に手術後の測定を行い翌23日に退院した。その後、同年5月31日に再発が確認された。
Claims (7)
- 尿中の胎盤性ロイシンアミノペプチダーゼからなるがんのバイオマーカー。
- がんが、卵巣がん、子宮体がん、腎臓がん、前立腺がん、胃がん、膵臓がん、食道がん、絨毛がん、または乳がんである請求項1に記載のバイオマーカー。
- がんが卵巣がんである請求項1に記載のバイオマーカー。
- 卵巣がんの発症を判定する方法であって、被験体の尿中の胎盤性ロイシンアミノペプチダーゼ量または胎盤性ロイシンアミノペプチダーゼ活性を測定する工程を含む方法。
- 被験体が、画像診断において悪性または非悪性の判定が困難な卵巣腫瘍を有する個体である請求項4に記載の方法。
- 卵巣がんの発症が、切除手術後の再発である請求項4に記載の方法。
- 胎盤性ロイシンアミノペプチダーゼ活性を測定する工程において、被験体の尿をメチオニン存在下でL−ロイシン−p−ニトロアニリドと反応させ、生成したp−ニトロアニリド量を測定する方法を用いる請求項4〜6のいずれかに記載の方法。
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